Abstract

Open access Reflection Physical exam: where’s the evidence? A medical student's experience 1 2 3 Scott M Seki, Katharine C DeGeorge, Margaret L Plews- Ogan, Andrew S Parsons To cite: Seki SM, DeGeorge KC, It was not so long ago that an attending physi- surprise that many of the manoeuvres we are Plews- Ogan ML, et al. Physical cian accused me of the following: ‘you’re taught are strongly supported in the litera- exam: where’s the evidence? A advocating for the elimination of the physical ture, especially when used as diagnostic aids medical student's experience. exam from medicine!’ We were on rounds within more comprehensive triaging scoring Fam Med Com Health 2020;8:e000284. doi:10.1136/ and debating the objectivity and merit of a systems (eg, clinical prediction rules). An fmch-2019-000284 single observer non- blinded prestudy/post- example is the Alvarado score, one method study, the Bush- Francis Catatonia Scale, as for predicting acute appendicitis in the a means of measuring clinical status after patient who presents with abdominal pain. an Ativan challenge. ‘The kind of improve- By incorporating subjective and objective ment you all are expecting is so obvious that elements of patient history and presenta- the scale becomes obsolete’, I argued, ‘And tion, one can use